Individual provider Active NPI

Edward Kanner, DC

  • Chiropractor
  • Southampton, PA
National Provider Identifier
1790905776
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC005275L Issued in PA
Practice address
1300 Industrial Blvd FL 1
Southampton, PA 18966-4029
Phone
(215) 207-1559
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC005275L PA Primary

Addresses

Primary practice location

1300 Industrial Blvd FL 1
Southampton, PA 18966-4029

Mailing address

11880 Bustleton Ave Ste 201
Suite 201
Philadelphia, PA 19116-2538
Phone (215) 207-1559

Other identifiers 2

IdentifierTypeStateIssuer
KA688402OtherPAMEDICARE
003349839OtherPAUNITEDHEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DC005275LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Chiro Care PC Chiropractor CurrentSince Jul 16, 2023 Accepting new patients
Dr Kanner Chiropractic Care PC Chiropractor CurrentSince Aug 10, 2025 Accepting new patients

Locations

1300 Industrial Blvd
Fl 1
Southampton, PA 18966
Phone (215) 207-1559

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1790905776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11880 BUSTLETON AVE STE 201",
            "address_2": "SUITE 201",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191162538",
            "telephone_number": "215-207-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 INDUSTRIAL BLVD FL 1",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "189664029",
            "telephone_number": "215-207-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNER",
        "first_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC005275L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "KA688402",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "003349839",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southampton, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.